Deming taught us that the problem is in the system -- and he's right again.

Mis-medication, wrong site surgery, infection and other nosocomial calamities occur despite the heroics of nurses, doctors, pharmacists and the many other specialists who keep hospitals going. Indeed, things would likely be much worse but for their heroics.

So what's the root cause of our health care crisis?

Tom Papas, the protagonist of the business novel, The Remedy, tries to answer this question in chapter 13.

He is in rough shape -- he might be losing his father to a mis-medication.

Tom's conclusion: the customer is not the customer.

Only patients, he concludes, can arbitrate the millions of daily decisions that comprise the provision of medical care.

Yet the patient is not the customer in these transactions.

As evidence he reflects on how difficult it has been for his family to get Safety, Quality or Cost information from hospitals.

"And why should they give me info?" he laments. "I'm not the customer."

I've gotten a lot of mail about this chapter!

So what do ya'll think? Is Tom right, or is he not thinking clearly because of his desperate situation?

Are there other root causes that are more important? Any other thoughts or insights?

1 comment:

Pascal - I think Healthcare is full of wonderful, caring people who are deeply concerned about their patients well being and safety.Unfortunately, they work in a system that reduces their ability to do the best for their patients. No one purposefully gives the wrong medication but on the other hand when it does happen, there is no improvement proces to ensure it doesn't happen again.It's the classic - good people working in broken processes with no way of improving them.